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ICD-10 Guide
ICD-10 CodesK08.492

K08.492

Billable

Partial loss of teeth due to other specified cause, class II

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/06/2025

Code Description

ICD-10 K08.492 is a billable code used to indicate a diagnosis of partial loss of teeth due to other specified cause, class ii.

Key Diagnostic Point:

K08.492 refers to partial loss of teeth due to other specified causes, classified as Class II. This condition can arise from various factors, including systemic diseases, trauma, or dental caries that are not classified under more specific codes. Clinically, patients may present with missing teeth that can affect their ability to chew and speak, leading to potential nutritional deficiencies and psychosocial impacts. The anatomy involved primarily includes the maxilla and mandible, where the teeth reside. Disease progression may vary based on the underlying cause; for instance, systemic diseases like diabetes can exacerbate periodontal disease, leading to tooth loss. Diagnostic considerations include a thorough dental examination, radiographic imaging, and possibly laboratory tests to identify underlying systemic conditions. Accurate diagnosis is crucial for appropriate management and treatment planning, which may involve restorative dentistry or prosthodontics to restore function and aesthetics.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires understanding of various underlying causes and their implications on oral health.
  • Treatment complexity: Management may involve multidisciplinary approaches including dental specialists.
  • Documentation requirements: Detailed clinical documentation is necessary to justify the use of this code.
  • Coding specificity: While specific, it requires careful differentiation from other codes related to tooth loss.

Audit Risk Factors

  • Common coding errors: Misuse of related codes due to lack of specificity.
  • Documentation gaps: Incomplete records that do not clearly outline the cause of tooth loss.
  • Billing challenges: Potential denials if documentation does not support the diagnosis.

Specialty Focus

Medical Specialties

Dentistry

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Oral and Maxillofacial Surgery

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related ICD-10 Codes

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical significance of K08.492 lies in its implications for patient health and quality of life. Partial loss of teeth can lead to difficulties in eating and speaking, which may affect nutritional intake and social interactions. Understanding the epidemiology of tooth loss due to various causes can help in developing preventive strategies and improving population health outcomes. Monitoring trends in tooth loss can also inform healthcare utilization patterns, guiding resource allocation and public health initiatives.

ICD-9 vs ICD-10

The clinical significance of K08.492 lies in its implications for patient health and quality of life. Partial loss of teeth can lead to difficulties in eating and speaking, which may affect nutritional intake and social interactions. Understanding the epidemiology of tooth loss due to various causes can help in developing preventive strategies and improving population health outcomes. Monitoring trends in tooth loss can also inform healthcare utilization patterns, guiding resource allocation and public health initiatives.

Reimbursement & Billing Impact

Reimbursement considerations may vary based on the payer, so it is essential to verify coverage policies. Best practices include maintaining thorough records of patient evaluations, treatment plans, and follow-up care to substantiate claims.

Resources

Clinical References

  • •
    ICD-10 Official Guidelines for K00-K99
  • •
    Clinical Documentation Requirements

Coding & Billing References

  • •
    ICD-10 Official Guidelines for K00-K99
  • •
    Clinical Documentation Requirements

Frequently Asked Questions

What specific conditions are covered by K08.492?

K08.492 covers partial loss of teeth due to specified causes such as trauma, systemic diseases, or other dental conditions that do not fall under more specific codes. It is important to document the underlying cause to support the use of this code.

When should K08.492 be used instead of related codes?

K08.492 should be used when there is a clear indication of partial tooth loss due to specified causes that are not adequately described by other codes. It is essential to differentiate it from K08.49, which is more general.

What documentation supports K08.492?

Documentation should include a comprehensive dental examination, radiographic evidence of tooth loss, and any relevant medical history that may contribute to the condition, such as systemic diseases or trauma.